<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">
    <title>Title</title>
    <script type="text/javascript" src="js/jquery-1.12.0.min.js"></script>
    <script src="layui/layui.all.js" charset="utf-8"></script>
    <link rel="stylesheet" href="layui/css/layui.css" media="all">
</head>
<body>
<div class="layui-form">
    <div class="layui-form-item">
        <label class="layui-form-label">国家</label>
        <div class="layui-input-inline">
            <input type="text" name="country" lay-verify="required" placeholder="暂时只支持中国境内" autocomplete="off"
                   class="layui-input" value="中国">
        </div>
        <label class="layui-form-label">省份</label>
        <div class="layui-input-inline">
            <input type="text" name="country" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">城市</label>
        <div class="layui-input-inline">
            <input type="text" name="city" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">区域</label>
        <div class="layui-input-inline">
            <input type="text" name="county" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">街道</label>
        <div class="layui-input-inline">
            <input type="text" name="street" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">详细地址</label>
        <div class="layui-input-inline">
            <input type="text" name="detailAddress" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">手机号</label>
        <div class="layui-input-inline">
            <input type="text" name="phoneNumber" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
        <label class="layui-form-label">姓名</label>
        <div class="layui-input-inline">
            <input type="text" name="name" lay-verify="required" placeholder="请输入" autocomplete="off"
                   class="layui-input">
        </div>
    </div>
    <div class="layui-form-item layui-hide">
        <input type="button" lay-submit="" lay-filter="btn_save" id="btn_save" value="保存">
        <input type="button" value="取消" class="back">
    </div>
    <script>
        $(".back").click(function () {
            close();
        })
    </script>
</div>
</body>
</html>
